SSI One Flashcards
What is the function of scrubs?
- Decrease debris and bacteria carried into the theatre by staff
- Comfortable, lint-free, durable and easy to launder
- 280 count better than 140 count
- barrier properties are lost after75 laundry cycles
- laundering doesnt sterilise
What is the function of a theatre hat?
- Reduces contamination of surgical wounds with bacteria
- Hair and beard should be fully covered
- Durable, Comfortable and Lint Free
What is the function of theatre shoes?
- Protects the operating room from external bacteria
What is the function of surgeon/ theatre masks?
- Protects the surgical wound from saliva droplets and microorganisms
- Redirects airflow out the sides of the mask
- Filters large particles well
What do you do during aseptic hand prep?
- Thorough scrub first
- Remove dirt and oil from hands
- Scrub should not be prolonged or cause trauma to the skin
- Use antiseptics
What is an antiseptic?
Chemical used on a patient or surgeon to kill microbial organisms
What is the definition of asepsis?
The absence of microbial organism on living tissues
What is an immediate action antiseptic?
Amount of micro organisms killed or mechanically removed within 3 minutes
What is a persistent action antibiotic?
Ability to prevent re-colonisation of skin up to 6 hours after application
What is a residual action antibiotic
Cumulative antimicrobial effectiveness after used for at least 5 days
What is the negative of double gloving?
Lose sensitivity of fingers/tactility
What do you need to be careful of during aseptic procedure?
Important not to cause any trauma to the skin
What is the purpose of patient preparation?
- Removes transient organisms
- Reduces endogenous bacterial microflora
What is the correct way to clip a patient?
- Wide clip with well prepared razor blades
- immediately prior to surgery
- Position for surgery
- Final aseptic skin prep
What is the purpose of drapes?
- Impermeable to fluid
- resistant to tearing
- secured to the patient
- sterile working area
What is the indicator that you need to use antibiotics peri-operative prophylactic antibiotics?
- Risk of infection
- Development of SSI would be catastrophic
What is the suggested use of peri-operative prophylactic antibiotics?
- Clean-contaminated, contaminated and dirty procedures
- Clean orthopaedic procedures
What are peri-operative prophylactic antibiotics?
- Intravenous
- Broad spectrum of antibiotics
- Use 30 minutes prior to incision
What antiseptic should not be used in ears?
Chlorrhexadine
Why should you handle tissue gently?
- Uninjured tissue takes 106 bacteria per g for infection to be established
- Injured/crushed tissue takes 103
Why do you need to be meticulous with haemostasis?
- Better perfusion = Better handling
- Better visualisation for the surgeon
- Clots in the surgical field are the perfect medium for bacterial growth
What is the best way to preserve the blood supply?
Do not ligate any major vessels
What is the function of perfusion?
Delivery of O2, Leukocytes and inflammatory proteins to healing tissues
What is the function of eliminating dead space?
- by suturing
- Reduces wound fluid accumulation
- allows tissue sealing to occur earlier
- lower risk of seroma/ abscessation less tension on the wound
What is the function of accurate tissue apposition?
- Aids and speeds healing
- Particularly important where leak proofing is neccesary
- Improved functional results
Why do you need to minimise tension on tissues?
Tension on tissues causes capillaries to collapse
How long does the fibrin seal last for?
6 hours
* waterproof but can be easily disrupted
How can the fibrin seal be disrupted?
- Tension
- Movement
- Licking
- Handling of the patient
What are two ways you can help reduce wound contamination?
- apply the barrier in an aseptic manner, whilst in theatre
- maintain the barrier carefully in hospital
What is a nosocomical infection?
Infection acquired within a hospital setting
How do you reduce Horizontal transmission
- Keep wound covered
- Hand hygeine before touching the patient
How do you reduce vertical transmission?
- Routine hospital cleaning
- Protocols
How would you treat SSI if theres no systemic signs?
- Treat as a traumatic infected wound
- swab for culture and sensitivity
- Broad spectrum pending results
How would you treat an SSI if it is septic?
- Aggressive treatment
- IVFT, antibiotics, analgesia
- Surgery once stable for GA
